Question

Which action by a billing and coding specialist would be considered fraud?

a) Verifying patient information
b) Accurately coding medical procedures
c) Billing for services not provided
d) Updating insurance information

Answer 1

Billing for services not provided is considered fraud for a billing and coding specialist, accurately coding medical procedures, and updating insurance information are all legitimate and necessary responsibilities of a billing and coding specialist to ensure accurate billing and reimbursement.

Step-by-step explanation:

The action that would be considered fraud for a billing and coding specialist is billing for services not provided. This means that the specialist is charging a patient or an insurance company for medical services that were not actually performed. This is unethical and illegal, as it involves falsely claiming reimbursement for services that did not take place.

Verifying patient information, accurately coding medical procedures, and updating insurance information are all legitimate and necessary responsibilities of a billing and coding specialist to ensure accurate billing and reimbursement.